Provider Demographics
NPI:1992308282
Name:LAUE, DEREK (DC)
Entity type:Individual
Prefix:
First Name:DEREK
Middle Name:
Last Name:LAUE
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18281 COTTONWOOD DR APT 205
Mailing Address - Street 2:
Mailing Address - City:PARKER
Mailing Address - State:CO
Mailing Address - Zip Code:80138-8974
Mailing Address - Country:US
Mailing Address - Phone:970-769-3094
Mailing Address - Fax:
Practice Address - Street 1:18886 E HAMPDEN AVE
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80013-3504
Practice Address - Country:US
Practice Address - Phone:303-622-3237
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-18
Last Update Date:2020-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COCHR.0008150111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor